Obese Men Face Twin Threat From Prostate Cancer

The standard screening test for prostate cancer may not be accurate for obese men, leaving them more vulnerable to the disease, and surgery is less likely to be effective for them, a new pair of studies found."Obese men are more likely to be diagnosed with an aggressive form of the disease," said Dr. Stephen Freedland, an associate professor of urology and pathology at the Duke University Prostate Center, and an author of one of the studies.

The reason: The blood test that looks for elevated levels of the protein prostate-specific antigen (PSA), indicating a heightened cancer risk, doesn't seem as reliable for obese men, Freedland said.

"Our assumption is that these men have more blood volume, so PSA gets diluted, he said. "By the time obese men get to elevated levels, the cancer is more advanced."

The study, published online Friday in the journal BJU International included nearly 3,400 men who had PSA tests. The researchers found that the risk of an aggressive cancer was doubled in obese men diagnosed because of high PSA levels. No such association was found for obese men diagnosed by a digital rectal examination, in which the physician feels for an abnormally large prostate gland.

Prostate cancer is suspected when the PSA reading is 4 or higher. The current recommendation is for men aged 50 and older to be offered an annual PSA test, with explanations of its possible risks and benefits. A federal preventive medicine committee this week said that PSA screening should not be done for men aged 75 and older because the risks outweigh the benefits.

"I'm not sure that we should check obese men more often," Freedland said. "But we should have a higher [PSA] index of suspicion of what is not normal -- 3.4 rather than 4; for really obese men, 3.2."

The Duke study measured obesity using body-mass index, which is a ratio of weight to height. Obesity is defined as a BMI of 30 or more.

A second report from Duke in the same issue of the journal found that excess weight influenced the outcome of surgery for prostate cancer. Men with a BMI of 35 or higher were nearly 60 percent more likely to have a recurrence of the cancer than thinner men, the study of 1,434 men found.

One reason is "the difficulty of operating on obese men in general," said study author Dr. Jayakrishnan Jayachandran, a urology oncology fellow at the Duke Prostate Cancer Center. "The prostate is a narrow thing to operate on, and when there is a big wad of fat in your way, if the abdominal wall is thick, it becomes a technical issue."

The result is that not all the cancer may be removed, which means a recurrence after time, Jayachandran said. "The only thing we can think of is that when you operate on obese people, you have to be more careful," he said.

The studies results apply to men who might not regard themselves as obese, Freedland said. "We can't forget that when we use the term, we are not just talking about very large men," he said. "A man who is 5 foot 9 and weighs 203 pounds would be considered obese."

Jayachandran added, "We are not screening these obese men effectively and are not doing as good a job surgically as could be done."

Mood hormone may affect fat, U.S. study finds

WASHINGTON (Reuters) - A brain chemical strongly linked to mood and appetite may also directly affect fat gain, U.S. researchers reported on Tuesday.

They said levels of serotonin, the nerve-signaling chemical targeted by many antidepressants, may also direct the body to put down fat regardless of how much food is eaten.

"It may be one reason diets fail," metabolism expert Kaveh Ashrafi of the University of California, San Francisco, who led the study, said in a telephone interview.

The findings, published in the journal Cell Metabolism, could lead to better diet drugs and treatments for diseases like diabetes.

Serotonin may help the body decide whether to burn off excess calories, or store them as fat, Ashrafi said.

He worked with roundworms for his experiment but said the findings may relate to humans. "These worms, although they are microscopic, they have around 20,000 genes ... and if you compare them side by side they are about 50 percent similar to us," he said.

Genes controlling appetite, fat storage and metabolism are especially similar, he said. The tiny worms can be manipulated to see changes to their metabolism, appetite and weight gain.

"It has been known for a long time that increasing serotonin causes fat reduction," Ashrafi said.

"At the molecular level we are trying to understand what is the mechanism that allows that to happen. What we discovered in the worm is that those mechanisms can be separated from the mechanisms that mediate the effects of serotonin on appetite."

The research found serotonin levels affected the worms' appetite, but they also affected how much fat the worms accumulated, and this was via a separate process.

If the worms detect a food shortage, their metabolisms shift and they store more fat. This could explain why some people get fat more easily than others -- and why dieting can cause more weight gain later.

"Different people may have similar diets, may have similar rates of physical activity, but may have very different body weights," Ashrafi said. "Appetite is only part of it."

But for now the remedy for excess body fat remains obvious. "Nothing in our study says that good nutrition and physical activity are not good for you," Ashrafi said.

Simply raising serotonin levels can have serious side-effects. The diet drug fenfluramine, which has the effect of raising serotonin levels, was pulled off the market in 1997 after it caused sometimes deadly heart valve damage.

Source: news.yahoo.com

Eating Habits Not Sole Cause of Thinness or Obesity

WEDNESDAY, June 4 (HealthDay News) -- Your nerves, rather than your eating habits, may have a more direct role in whether you are fat or thin, according to new research.

A study on worms shows that serotonin levels in the nervous system influence feeding and fat. Serotonin, a neurotransmitter, also acts independently to control eating and what your body does with those calories once they've been consumed, the study said.

"It says that the nervous system is a key regulator coordinating all energy-related processes through distinct molecular pathways," Kaveh Ashrafi, of the University of California, San Francisco, said in a prepared statement. "The nervous system makes a decision about its state leading to effects on behavior, reproduction, growth and metabolism. These outputs are related, but they are not consequences of each other. It's not that feeding isn't important, but the neural control of fat is distinct from feeding."

Ashrafi said that given serotonin's ancient evolutionary origins, you can apply what's learned from the worms to humans.

"From a clinical perspective, this may mean you could develop therapeutic strategies to manipulate fat metabolism independently of what you eat," he said. "Now, the focus is primarily on feeding behavior. As important as that is, it's only part of the story. If the logic of the system is conserved across species, a strategy that focuses solely on behavior can only go so far. It may be one reason diets fail."

The findings were published in the June issue of Cell Metabolism.

At its most basic level, fat regulation is the balance between energy intake and expenditure; however, Ashrafi said the physiology is very complicated.

In the worms, serotonin affected feeding by involving nerve receptors not normally required for fat control. The byproducts of the signaling process ended up affecting the control of feeding behavior, Ashrafi said.

In the worms and in mammals, high serotonin levels are associated with fat reduction, while low serotonin levels lead to fat accumulation, the researchers noted. However, in the worms, when serotonin goes up, the worms desire to eat increases even as fat melts away. But in humans, high serotonin leads people to eat less and shed fat.

Serotonin's effects on fat and eating habits in the worms fit the nerve messenger's role as a sensory gauge of nutrient availability, the researchers said. When resources are scarce, worms build up their fat reserves and switch metabolic gears to save energy and direct nutrients to fat stores.

Ashrafi said serotonin's role in balancing energy across species leads him to believe that "human counterparts of feeding-independent fat regulatory genes identified in our study may similarly regulate energy balance."

Lifestyle change key for obesity surgery success

NEW YORK (Reuters Health) -
Anyone thinking about having
weight loss surgery should be sure to do their homework
beforehand, and must understand they need to dramatically
change the way they eat for the surgery to be successful,
advises the head of the U.S. government agency responsible for
research on health care quality and patient safety.

"People who succeed and lose weight and keep it off eat
very, very differently," Dr. Carolyn Clancy, director of the
Agency for Healthcare Research and Quality (AHRQ) in Rockville,
Maryland, told Reuters Health. "Essentially, you've got to eat
a whole lot less."

Clancy has written about the realities of operations to
promote weight loss, known as bariatric surgery, in the latest
issues of Nursing for Women's Health and Health for Women, both
published by the Association of Women's Health, Obstetric and
Neonatal Nurses.

Bariatric surgery has skyrocketed in popularity, Clancy
noted in an interview, but just a fraction of people who could
benefit most from the surgery have gotten it. According to
AHRQ, evidence for the procedure's benefits is strongest for
people with body mass indexes (BMIs) of 40 or higher, or
individuals with BMIs of 35 or greater who have a serious
medical condition, such as diabetes or severe sleep apnea.

Nevertheless, she added, the surgery "is not risk free, and
I think it's really important for all people, women and men, to
know about the risks and to be very clear about what they're
getting into."

For example, Clancy said, 7 percent of people who undergo
the surgery need to be rehospitalized for complications. Four
out of 10 will develop complications within 6 months of the
surgery. These complications include nausea, cramps and
vomiting due to overeating.

People should also seek out a surgeon and health care team
they can communicate with effectively, because post-surgical
follow-up care is just as important as the procedure itself,
Clancy added. If you don't "click," or you feel your surgeon
isn't hearing your concerns, she advised, look elsewhere.

People may want to seek out bariatric surgery programs
designated as Centers of Excellence by the American Society for
Metabolic and Bariatric Surgery (http://www.asbs.org/), Clancy
suggested.

Finally, she said, people need to find out before having
the surgery whether or not their insurer covers it. Some will
require documentation that a person has made a serious effort
to lose weight by other means before they will pay for the
procedure.

SOURCE: Nursing for Women's Health, February/March 2008.

School nutrition policy can prevent obesity

NEW YORK (Reuters Health) -
Philadelphia schools that cut
out soda, revamped snack selections and took other measures to
prevent childhood obesity were able to halve the odds of
students becoming overweight by sixth grade, a study has found.

Among fourth-graders at five schools that instituted the
new nutrition policy, 7.5 percent became overweight over the
next 2 years, compared with 15 percent of students at five city
schools that did not make the changes, researchers report in
the journal Pediatrics.

The findings show that a comprehensive approach to battling
childhood obesity in schools can make a significant difference,
according to lead researcher Dr. Gary D. Foster of Temple
University.

Schools have been at the center of the controversy over
what to do about U.S. children's rising rates of overweight and
obesity. Critics have pointed to vending machines, sugary "a la
carte" items in school cafeterias, and reductions in gym class
as part of the problem.

At the same time, schools are considered the ideal place
for children to learn healthy eating and exercise habits, and
various school-based programs have been developed with that
aim. The results have been mixed, however.

For their study, Foster and his colleagues evaluated a
program developed by a non-profit community group called the
Food Trust. Ten schools enrolled in the study; half were
randomly assigned to adopt the nutrition program, while the
other half served as a comparison group.

Schools in the program made an array of changes. They
replaced soda with water, low-fat milk and 100-percent fruit
juice, and rid vending machines and cafeterias of snacks that
did not meet certain nutrition criteria. They educated students
on how diet and exercise affect their health, and gave them
raffle tickets for bikes and other prizes to reward them for
choosing healthy snacks.

The schools also got parents involved through meetings and
nutrition workshops that encouraged them to give their kids
more fruits, vegetables and other healthy foods.

Among the 1,349 students Foster's team followed from fourth
to sixth grade. As mentioned, there was about a 50 percent
reduction in the incidence (new cases) of overweight at the end
of 2 years among the children attending the program schools,
while no changes were seen among the children attending the
schools without a program.

The prevalence (total number) of overweight children also
declined during the study period in the program group. However,
no differences in the prevalence of obesity were seen between
the program group and the comparison group.

The results, Foster told Reuters Health, underscore the
benefits of schools having a comprehensive nutrition program,
rather than taking only individual measures -- like removing
vending machines, for instance.

He and his colleagues also stress that the urban schools in
this study had largely low-income, minority student populations
-- children who are at particularly high risk of obesity. Black
children appeared to particularly benefit from the nutrition
policy.

In the sixth grade, the study found, African-American
children in these schools were 41 percent less likely to be
overweight than African Americans in the comparison schools.

Despite the success, Foster's team writes, the fact that
7.5 percent of children in the program schools still became
overweight shows that even more needs to be done.

They say that obesity-prevention programs should start
before fourth grade, and possibly include a broader range of
measures -- such as devoting more time to gym class and
enlisting the corner stores near schools to offer healthier
snack options.

SOURCE: Pediatrics, April 2008.

Dad's early obesity tied to liver disease in kids

NEW YORK (Reuters Health) -
Having a father who becomes
obese at a relatively young age may increase a person's risk of
developing serious liver problems, a new study shows.

Individuals whose fathers were obese before age 45 were
more likely than those whose parents were not obese to have
high levels of alanine aminotransferase (ALT) in their blood,
an enzyme that signals liver injury, Dr. Rohit Loomba of the
National Institutes of Health in Bethesda, Maryland and
colleagues found.

High ALT levels in the general population can be associated
with non-alcoholic fatty liver disease, an obesity-related
condition, Loomba and his team say. One severe, progressive
form of non-alcoholic fatty liver disease is nonalcoholic
steatohepatitis, which can lead to cirrhosis and even liver
cancer, they note in the medical journal Gastroenterology.

To investigate whether parental obesity might be related to
high ALT levels, as well as levels of another enzyme related to
liver damage, aspartate aminotransferase (AST), the researchers
looked at measurements of both enzymes in 1,732 men and women
participating in the Framingham Heart Study.

The researchers divided study participants into three
groups: people whose parents became obese unusually early
(before age 41 for women and before age 45 for men), those with
parents who became obese later on, and those with parents who
were never obese.

Having a father with early-onset obesity increased a
person's likelihood of having elevated ALT levels, regardless
of their own weight, the researchers found. But there was no
link between maternal obesity and ALT levels, and no
relationship at all between parental obesity and AST levels.

Developing a condition like obesity early can indicate
genetic susceptibility to that condition, the researchers note
in their report. The findings suggest that genes that promote
early-onset obesity could also influence ALT levels, they add.

"These results support the need for further studies to
establish whether individuals with early-onset parental obesity
and elevated serum ALT levels are at a higher risk for
developing progressive liver disease such as nonalcoholic
steatohepatitis," the researchers conclude.

SOURCE: Gastroenterology, April 2008.

Metabolic Syndrome Triggered by Overeating, Not Obesity

(HealthDay News) -- Overeating, not the obesity
it causes, is the actual cause of metabolic syndrome, suggests a study
with mice by researchers at the University of Texas Southwestern Medical
Center at Dallas.

Metabolic syndrome is a collection of health factors that increase the
risk of developing insulin resistance, fatty liver, heart disease and type
2 diabetes.

This study was among the first to propose that weight gain is an early
symptom, not a direct cause, of metabolic syndrome, the researchers
said.

"Most people today think that obesity itself causes metabolic
syndrome," senior author Dr. Roger Unger, professor of internal medicine,
said in a prepared statement. "We're ingrained to think obesity is the
cause of all health problems, when, in fact, it is the spillover of fat
into organs other than fat cells that damages these organs, such as the
heart and the liver. Depositing fatty molecules in fat cells where they
belong actually delays that harmful spillover."

In this study, Under and his colleagues compared normal mice to mice
that were genetically altered to prevent their fat cells from expanding.
Both groups of mice were overfed.

The normal mice got fat but didn't develop signs of metabolic syndrome
until after about seven weeks of overeating. The genetically altered mice
stayed slim but became seriously ill within a few weeks and displayed
evidence of severe heart problems and major increases in blood sugar
levels eight weeks before minimal heart problems developed in the normal
mice, the researchers said.

The genetically altered mice showed significant damage to heart cells
and to the insulin-secreting cells in the pancreas. They also got sick
quicker, because the extra calories they consumed weren't stored in fat
cells, but rather in other tissues, the researchers said.

The study was published online in the journal Proceedings of the
National Academy of Sciences.

Canadian cancer survivors obese and inactive

WASHINGTON (Reuters) -
Cancer survivors in Canada are more
likely to be obese and less likely to exercise than the rest of
the population -- putting themselves at risk of having their
cancers come back, researchers said on Monday.

The trends, likely to be seen in cancer survivors around
the world, suggest patients need help and support in staying
active and keeping the weight off, said Kerry Courneya of the
University of Alberta in Edmonton, who led the study.

"It's a challenge for all of us to eat properly and
exercise, and it may be especially challenging for cancer
survivors who have been through difficult treatments and may
have lingering health issues," Courneya said in a statement.

"But eating well and exercising are two of the best things
we can do for our mental and physical health, even in trying
times. Rest is rarely the best medicine for any health
condition."

Courneya and colleagues analyzed data from a 2005 survey of
more than 114,000 adults.

Fewer than 22 percent of former cancer patients described
themselves as physically active. This compares with 25 percent
of the general Canadian population, they reported in the
journal Cancer.

They also found that 18 percent of cancer survivors were
medically obese, compared to 15 percent of the general
population, and 34 percent were overweight.

Many cancers are linked with obesity and a lack of
exercise.

"These findings tell us that we need to look at ways to
better support cancer survivors to become more active and to
maintain a healthy body weight," Courneya said.

"We know that physical inactivity and obesity are risk
factors for developing cancer. These are also risk factors for
the recurrence of cancer. Lifestyle is just as important after
diagnosis."

The researchers defined someone as physically active if
they walked at least an hour a day or did the equivalent in
swimming, cycling or some other activity. Inactive people
walked or exercised less than 30 minutes a day.

(Reporting by Maggie Fox, editing by Todd Eastham)

Many Cancer Survivors Are Overweight and Sedentary

(HealthDay News) -- A healthy lifestyle may help
cancer survivors prevent recurrence of the disease and live longer, yet
cancer survivors have rates of obesity and physical inactivity similar to
those of the general population, according to new research.

The study, published in the June 1 issue of Cancer, found that
less than one-quarter of cancer survivors were regularly physically
active, and more than 18 percent were obese.

"We thought this might be a time when people would be particularly
motivated to exercise and control weight. But, a cancer diagnosis and
treatment didn't seem to stimulate behavior change," said the study's lead
author, Kerry Courneya, a professor and Canada Research Chair at the
University of Alberta in Edmonton, Canada.

What's troubling is that maintaining a healthy weight and getting
regular physical exercise may be even more crucial for cancer survivors
than it is for the general public. Some studies have suggested that
physical activity and losing weight may help prevent cancer recurrence and
improve survival odds.

Additionally, some research suggests that exercise can help reduce
fatigue, improve physical functioning and improve quality of life for some
cancer survivors.

For the study, Courneya and his colleagues gathered data from the
Canadian Community Health Survey. This survey contains information based
on interviews of more than 114,000 people in Canada. Details of cancer
history, weight, height and physical activity were all supplied by the
respondents.

General population statistics for Canada find that 37 percent of people
are overweight, and 22 percent are obese, according to background
information in the study.

Fewer than 22 percent of cancer survivors reported being physically
active. The lowest rates of physical activity were found among colorectal
cancer survivors, breast cancer survivors and female survivors of
melanoma.

Thirty-four percent of cancer survivors were overweight, and almost one
in five was obese.

Obese breast cancer survivors were only about half as likely to be
physically active as obese women who hadn't had cancer, a finding that's
particularly worrisome, because poor outcomes in breast cancer have been
associated with obesity and the often accompanying sedentary lifestyle.

"We really didn't know which way the research would go. Cancer
survivors may be more motivated at the time of their diagnosis to make
changes, but others point out that it's a very stressful time that can
take a toll and lead to the opposite effect," Courneya said.

Kevin Stein, director of Quality of Life Research at the American
Cancer Society, said, "This is an important finding to underscore the fact
that cancer survivors need to pay attention to their health. You've
dodged a bullet for the time being, but cancer survivors are actually at
an increased risk for a number of health conditions, including cancer
recurrence.

"There is a teachable moment when someone is diagnosed. It's the
perfect opportunity to say, 'We all need to eat healthy and exercise, but
it's even more important for you as a cancer survivor,' " he said.

Courneya added: "This is something they can do for themselves to help
beat cancer and improve quality of life. The cancer community needs to get
more involved in the promotion of healthy lifestyles in cancer patients.
Maybe a program something like cardiac rehabilitation. The cancer
community's been slower to realize the importance of lifestyle changes
after cancer diagnosis."

Obesity, smoking cuts many US women's life expectancy: study

WASHINGTON (AFP) -
Life expectancy has declined for many women in the United States, largely due to smoking-related diseases and obesity, a study published Tuesday showed.

Nearly one in five US women saw the number of years they are expected
to live decline or hold steady, starting in the 1980s, showed the joint
study by the Harvard School of Public Health and the University of Washington.

The study looked at data from more than 2,000 county "units" between 1959 and 2001.

In around 1,000 of those counties -- mainly poor, rural areas -- life
expectancy for women dropped starting in the 1980s, "primarily because
of chronic diseases related to smoking, overweight and obesity, and high blood pressure," according to the study.

In the United States as a whole, in contrast, life expectancy for women
rose by more than six years and for men by more than seven years during
the same period, it showed.

"There is now evidence that there are large parts of the population in
the United States whose health has been getting worse for about two
decades," Majid Ezzati, associate professor of international health at
the Harvard School of Public Health, and lead author of the study, said
in a statement.

Worst affected by the downturn in longevity were the south -- the region hardest hit by poverty, according to the US Census Bureau -- the Appalachians, southern parts of the Midwest and areas of Texas.

Men in the same areas also saw a drop in life expectancy, but numbers
were less alarming than among women -- only four percent -- and the
fall was attributed to different causes, mainly HIV/AIDS and homicide.

"Life expectancy decline is something that has traditionally been
considered a sign that the health and social systems have failed, as
has been the case in parts of Africa and Eastern Europe," said the
study's co-author Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

"The fact that this is happening to a large number of Americans should be a sign that the US health system needs serious rethinking," he added.

Obesity, low birthweight mar health of kids

CHICAGO (Reuters) -
Rising obesity rates and a large
percentage of children born with low birthweight are dragging
down the overall health of American children in their first
decade of life, according to a report tracking the health and
well-being of young children in the United States.

While U.S. children overall have seen improvements in their
well-being in recent years, American children aged 6 to 11 are
four times more likely to be obese than similarly aged children
in the 1960s, the report found.

The report, led by researchers at Duke University in North
Carolina and the Foundation for Child Development, a private
advocacy group, looked at the well-being of children in early
childhood, those from birth to age five, and middle childhood,
or those aged 6 to 11, from 1994 to 2006.

The researchers found obesity among children in middle
childhood is nearly four times more common than in children of
the same age in a national survey in 1960s. For children aged 2
to 5, it is three times higher.

"These are dramatic increases in the prevalence of
overweight children in American society from one generation to
the next," the researchers wrote. "The importance of this trend
for the health and well-being of children is difficult to
exaggerate."

They said overweight children have greater risks of type 2
diabetes, and often have elevated risk factors associated with
heart disease, such as high cholesterol and high blood
pressure.

They also found that the percentage of babies born with low
birthweight rose 12.3 percent from 1994 to 2005, an increase
they said was likely tied to delayed childbearing among working
mothers and an increased use of fertility drugs.

Low birthweight has been linked in large studies to a
higher risk of developmental and learning problems and to lower
academic achievement. It also has been linked with higher rates
of chronic health conditions.

Other trends were more positive.

The researchers found significant improvements in the
mortality rates of children, with the most dramatic improvement
for children aged 1 to 4. Death rates among these children fell
to 29.4 deaths in 100,000 in 2005, compared with 42.9 deaths
per 100,000 in 1994.

For those aged 5 to 9, rates of death fell 27 percent to
14.5 deaths per 100,000 in 2005.

The researchers cite a host of contributing factors,
ranging from better health care and nutrition to car safety
seats.

The report also noted a dramatic 84 percent drop in the
rates of lead poisoning among children aged 0 to 6. Lead
poisoning can result in physical, neurological and cognitive
problems.

Still, many children remain at risk for moderate levels of
lead in their blood should continue to be monitored, they said.

Obesity and low birthweight mar health of kids

While U.S. children overall have seen improvements in their
well-being in recent years, American children aged 6 to 11 are
four times more likely to be obese than similarly aged children
in the 1960s, the report found.

The report, led by researchers at Duke University in North
Carolina and the Foundation for Child Development, a private
advocacy group, looked at the well-being of children in early
childhood, those from birth to age five, and middle childhood,
or those aged 6 to 11, from 1994 to 2006.

The researchers found obesity among children in middle
childhood is nearly four times more common than in children of
the same age in a national survey in 1960s. For children aged 2
to 5, it is three times higher.

"These are dramatic increases in the prevalence of
overweight children in American society from one generation to
the next," the researchers wrote. "The importance of this trend
for the health and well-being of children is difficult to
exaggerate."

They said overweight children have greater risks of type-2
diabetes, and often have elevated risk factors associated with
heart disease, such as high cholesterol and high blood
pressure.

They also found that the percentage of babies born with low
birthweights rose 12.3 percent from 1994 to 2005, an increase
they said was likely tied to delayed childbearing among working
mothers and an increased use of fertility drugs.

Low birthweight has been linked in large studies to a
higher risk of developmental and learning problems and to lower
academic achievement. It also has been linked with higher rates
of chronic health conditions.

Other trends were more positive.

The researchers found significant improvements in the
mortality rates of children, with the most dramatic improvement
for children aged 1 to 4. Death rates among these children fell
to 29.4 deaths in 100,000 in 2005, compared with 42.9 deaths
per 100,000 in 1994.

For those aged 5 to 9, rates of death fell 27 percent to
14.5 deaths per 100,000 in 2005.

The researchers cite a host of contributing factors,
ranging from better health care and nutrition to car safety
seats.

The report also noted a dramatic 84 percent drop in the
rates of lead poisoning among children aged 0 to 6. Lead
poisoning can result in physical, neurological and cognitive
problems.

Still, many children remain at risk for moderate levels of
lead in their blood should continue to be monitored, they said.

(Reporting by Julie Steenhuysen, Editing by Maggie Fox and
Cynthia Osterman)

Overweight warning: More than exercise needed

"Even high quantities of physical activity are unlikely to
fully reverse the risk of coronary heart disease in overweight
and obese women without concurrent weight loss," Dr. Amy
Weinstein and colleagues at Boston's Beth Israel Deaconess
Medical Center reported.

"Regardless of body weight, (the findings) highlight the
importance of counseling all women to participate in increasing
amounts of regular physical activity and maintaining a healthy
weight to reduce the risk of coronary heart disease," they
concluded.

The study, appearing in the Archives of Internal Medicine,
was based on information from a study of nearly 39,000 women
that began in 1992 and traced a number of health issues.

The researchers said 34 percent of the women in the study
were physically active based on government guidelines, 31
percent were overweight and 18 percent were obese.

In the end, 948 women were diagnosed with heart disease.
Active women with normal weight had the lowest risk of
developing heart problems while there was a slightly higher
risk for those with normal weight who were not active.

The risk was next highest for active women who were either
overweight or obese, and highest for similar women who were
inactive.

Fat cells produce chemicals that can speed up hardening of
the arteries and increase inflammation, the researchers said,
harming blood vessels, while physical activity makes for
healthier blood vessels and reduces the risk of blood clots.

(Reporting by Michael Conlon; editing by Maggie Fox and
Bill Trott)

source:news.yahoo.com

Gastric Bypass May Also Relieve Low Back Pain

(HealthDay News) -- Obese people who underwent surgery
that reduced the amount of food they could ingest not only lost weight,
they also lost some of their lower back pain, according to a new report.

Thirty-eight morbidly obese patients with low back pain who underwent
gastric bypass surgery reported that their pain decreased by an average of
about 44 percent six months after surgery, according to researchers at the
University of Southern California. The average amount of individual
weight loss among the group of 30 women and eight men was about 85 pounds.

"This study provides evidence that substantial weight reduction
following bariatric surgery results in moderate reductions in pre-existing
back pain within six months of weight loss. While this initial research
is promising, larger long-term trials are needed to prove the efficacy of
this treatment," Dr. Paul Khoueir said in a prepared statement.

Khoueir was expected to present the findings in Chicago April 29 at the
annual meeting of the American Association of Neurological Surgeons.

According to recent statistics, more than one-third of U.S. adults --
more than 72 million people -- were obese in 2005-2006. An estimated 75
percent to 85 percent of all Americans will experience some form of back
pain during their lifetime.

Obese people are known to have a higher rate of hip and knee arthritis,
but little is known about the extra weight's effect on lumbar spinal
degeneration. While obese patients with back pain are frequently advised
to lose weight, the association between these medical conditions remains
unproven.

source:news.yahoo.com

Asthma attacks worsened by obesity

NEW YORK (Reuters Health) -
In asthma patients, dynamic
hyperinflation, following a test measure airway
hypersensitivity, is greater in obese individuals than in their
nonobese counterparts, which helps explain why asthma is
perceived to be more severe in patients with a higher body mass
index (BMI), investigators in New Zealand report.

A BMI is the ratio between height and weight, and is used
to classify people as underweight, overweight or normal weight.

"The greater dynamic hyperinflation means that obese
individuals lose the ability to inhale as deeply or exhale as
fully as normal weight individuals," Dr. D. Robin Taylor
explains in an American Thoracic Society statement.

Taylor's team at the University of Otago in Dunedin studied
the changes in airway expansion and lung volume that occur with
acute constriction of the bronchial tubes in a group of 30
adult women with asthma. Ten women each were classified as
normal weight, overweight, or obese, and lung volumes were
measured.

The degree of bronchial constriction following the airway
sensitivity test did not vary by group, the team reports in the
American Journal of Respiratory and Critical Care Medicine. The
only significant difference among the subjects was a decrease
in vital capacity that significantly corresponded with
increasing BMI.

Lung volume measurements also showed that the volume of air
retained in the lung following exhalation was significantly
higher as BMI increased, while the amount of air that could be
inhaled was lower.

These variations "were significantly greater in relation to
BMI" after taking into account the effects of "airway
hyperresponsiveness, the severity of airflow obstruction, and
lung volume measurements, indicating the effect of BMI was an
independent one," the investigators note, meaning that BMI
alone was associated with the severity of asthma.

This puts obese individuals at greater disadvantage due to
enhanced gas trapping, they point out, a significant
contributor to difficulty in breathing.

Taylor and his associates also noted that conventional lung
function tests "may have limitations when used to evaluate
symptoms in obese patients with asthma, with the potential for
misinterpretation" in the absence of lung volume measurements.

source:news.yahoo.com

Special Diet Can Ease Epileptic Seizures in Kids

(HealthDay News) -- The "ketogenic" diet, which
features high levels of fat, low levels of carbohydrates and controlled
protein intake, helps control and prevent seizures in children with
drug-resistant epilepsy, a new study finds.

The trial is the first randomized controlled study to confirm that the
ketogenic diet -- widely used since the 1920s -- is effective against
epilepsy, the British researchers said.

Experts believe that the regimen's high fat and restricted carbohydrate
content mimics the biochemical response to starvation, when compounds
called ketone bodies (rather than sugar) provide the main source of energy
for the brain.

Ketone bodies are byproducts produced when fatty acids are broken down
for energy in the liver and kidneys. They are used as energy sources in
the heart and brain. In the brain, ketone bodies are a crucial source of
energy when a person fasts.

This University College London study included 145 children, aged 2 to
16, who suffered seizures at least once a day or more than seven seizures
per week. These patients hadn't responded to treatment with at least two
epileptic drugs, and hadn't previously been placed on the ketogenic
diet.

Baseline information about the children's seizures was first recorded.
Seventy-three of the children started the ketogenic diet immediately,
while the other 72 started it after a three-month delay. The delay group
acted as a control group during the study. Complete data was obtained from
54 children in the diet group and 49 children in the control group.

The overall number of seizures in the diet group declined by more than
38 percent, while seizures in the control group increased by 36.9 percent,
the researchers report. The study found that 28 of the 54 children who
completed three months in the diet group had a greater than 50 percent
reduction in seizures, compared to four of 49 children in the control
group. Five children in the diet group had more than 90 percent fewer
seizures. None of the children in the control group experienced that kind
of improvement.

The study appears in the current online edition of The Lancet
Neurology and will appear in the June print issue.

"We have shown that the diet has efficacy and should be included in the
management of children who have drug-resistant epilepsy. However, the diet
is not without possible side effects, which should be considered alongside
the risk-benefit of other treatments when planning the management of such
children," the study authors wrote.

More information is needed about the long-term effects of the ketogenic
diet, such as changes in blood fat concentrations and ketosis, Dr. Max
Wiznitzer, of Rainbow Babies and Children's Hospital in Cleveland, wrote
in an accompanying comment article.

"Better identification of epilepsies that benefit from starting early
on the ketogenic diet and comparisons between the choices of ketogenic
diet are needed," he wrote.

news.yahoo.com

Obesity May Worsen Impact of Asthma

(HealthDay News) -- A study of women with a wide
range of body-mass indexes (BMIs) found that obesity may worsen the impact
of asthma and also mask its severity in standard tests.

"We have demonstrated significant differences in the changes in
respiratory function that occur with asthmatic bronchoconstriction in
relation to obesity," principal investigator Dr. D. Robin Taylor, of the
University of Otago in New Zealand, said in a prepared statement.

The study also found that simple spirometry couldn't determine the
level of pulmonary dysfunction in obese people with asthma.

The findings were published in the first issue for May of the
American Journal of Respiratory and Critical Care Medicine. It's
the first prospective study to find a significant comparative difference
between obese and non-obese people in how the lungs and airways respond to
a simulated asthma attack.

The researchers said it establishes a direct link between obesity and
the development of dynamic hyperinflation -- air breathed into the lungs
can't be expelled. This often occurs with acute asthma, but is more
frequent in obese people.

The study included 30 asthmatic women who were divided into three
groups based on their BMI: normal weight, overweight and obese. All the
women breathed nebulized methacholine to induce an asthma-like attack and
were then assessed for changes in lung function, including functional
residual capacity (FRC -- how much air remained in the lungs after
exhalation) and inspiratory capacity (IC -- how much air could be inhaled
on the next breath).

"After the methacholine challenge, the amount of bronchoconstriction
was identical for each of the three groups, but the changes in FRC and IC
were greatest in the obese group. This indicated to us that greater
dynamic hyperinflation was occurring among obese individuals," Taylor
said.

The greater a woman's BMI, the higher her FRC and the lower her IC.

"This means that among women with greater BMI, an asthma-like episode
has the potential to cause greater breathing difficulties than in
non-obese women. The greater dynamic hyperinflation means that obese
individuals lose the ability to inhale as deeply or exhale as fully as
normal weight individuals," Taylor said.

The findings suggest fundamental differences in the way that obese
people with asthma may experience shortness of breath.

"We know that asthma in obese subjects is more likely to persist and is
more likely to be perceived to be severe. These individuals often require
more treatment to achieve asthma control. Our study provides an insight
into why this might be happening -- the same asthma trigger produces a
greater effect in obese individuals," Taylor said.

More research is needed to "confirm that the differences in dynamic
hyperinflation between obese and non-obese asthmatics are sufficient to
explain the differences in symptoms between the two groups. Our study was
not large enough to do this," Taylor said.

source:news.yahoo.com

High-fat, low-carb diet helps kids with epilepsy

NEW YORK (Reuters Health) -
The results of a study provide
strong evidence that a diet high in fat and low in
carbohydrates -- a so-called "ketogenic diet" -- can help
control seizures in children with stubborn epilepsy that does
not respond well to drug therapy.

Epilepsy is a common neurological disorder characterized by
recurrent seizures when the normal working of the brain is
interrupted. A ketogenic diet has been widely used since the
1920s to help control hard-to-treat seizures in children.

In their study, Dr. Elizabeth G. Neal, from University
College London, and colleagues randomly assigned a group of
children who were having at least seven epileptic fits per week
despite anti-epileptic drug therapy, to a standard diet or a
ketogenic one, which is typically high in fats and very low in
carbohydrates.

After three months, children on the ketogenic diet had more
than one third fewer seizures, while seizure frequency
increased in children on the standard diet, the researchers
report in the Lancet Neurology medical journal.

A greater than 50 percent drop off in seizure frequency was
noted in 38 percent of children on the ketogenic diet compared
with just 6 percent of children on the standard diet.

This study confirms that a ketogenic diet is safe and
effective in children with drug-resistant epilepsy, the
investigators conclude.

The most common side effects with the ketogenic diet were
constipation, vomiting, lack of energy, and hunger, Neal and
colleagues note.

In a written commentary, Dr. Max Wiznitzer, from the
Rainbow Babies and Children's Hospital in Cleveland, notes that
some questions still remain regarding ketogenic diets for
childhood epilepsy. Among these are the long-term effects, the
identification of epilepsies that benefit from early initiation
of such a diet, and the mechanism by which the diet produces
its anti-seizure effect.

SOURCE: Lancet Neurology, online May 3, 2008.

High-fat, low-carb diet helps kids with epilepsy

NEW YORK (Reuters Health) -
The results of a study provide
strong evidence that a diet high in fat and low in
carbohydrates -- a so-called "ketogenic diet" -- can help
control seizures in children with stubborn epilepsy that does
not respond well to drug therapy.

Epilepsy is a common neurological disorder characterized by
recurrent seizures when the normal working of the brain is
interrupted. A ketogenic diet has been widely used since the
1920s to help control hard-to-treat seizures in children.

In their study, Dr. Elizabeth G. Neal, from University
College London, and colleagues randomly assigned a group of
children who were having at least seven epileptic fits per week
despite anti-epileptic drug therapy, to a standard diet or a
ketogenic one, which is typically high in fats and very low in
carbohydrates.

After three months, children on the ketogenic diet had more
than one third fewer seizures, while seizure frequency
increased in children on the standard diet, the researchers
report in the Lancet Neurology medical journal.

A greater than 50 percent drop off in seizure frequency was
noted in 38 percent of children on the ketogenic diet compared
with just 6 percent of children on the standard diet.

This study confirms that a ketogenic diet is safe and
effective in children with drug-resistant epilepsy, the
investigators conclude.

The most common side effects with the ketogenic diet were
constipation, vomiting, lack of energy, and hunger, Neal and
colleagues note.

In a written commentary, Dr. Max Wiznitzer, from the
Rainbow Babies and Children's Hospital in Cleveland, notes that
some questions still remain regarding ketogenic diets for
childhood epilepsy. Among these are the long-term effects, the
identification of epilepsies that benefit from early initiation
of such a diet, and the mechanism by which the diet produces
its anti-seizure effect.

SOURCE: Lancet Neurology, online May 3, 2008.

Obese moms-to-be have longer pregnancies

NEW YORK (Reuters Health) -
Pregnant women who are
overweight or obese in the first trimester of pregnancy and
those who have a greater change in body weight during pregnancy
are more apt to have lengthier pregnancies and more
complications, according to results of a new study.

Dr. Fiona C. Denison, of the University of Edinburgh, UK,
and colleagues analyzed data from the Swedish Medical Birth
Register on women who gave birth between 1998 and 2002.

Out of 143,519 pregnancies, 6.8 percent were delivered
"postdate" -- defined as longer than 42 weeks. A normal
pregnancy lasts 40 weeks.

Compared with women with normal body mass indexes (BMIs),
more women with higher BMIs during the first trimester, as well
as those with greater weight gain during pregnancy, had
longer-than-normal pregnancies.

Being overweight or obese during the first trimester was
also associated with a lower chance of spontaneous delivery at
term and being obese was associated with a higher risk of
stillbirth, pregnancy-related (gestational) diabetes and need
for cesarean delivery.

"Maternal obesity poses a significant risk to maternal and
fetal health during pregnancy, and our study confirms the
findings of others that obesity is associated with significant
complications including stillbirth, gestational diabetes,
pregnancy-induced hypertension and cesarean section," Denison's
team concludes.

"If a healthy lifestyle including physical activity and
healthy eating, which are more common in underweight women,
were advocated more strongly for the obese obstetric
population," they suggest, "then obstetric outcomes might be
improved."

source:news.yahoo.com